Weight loss reins in diabetes

By CLAUDIA PINTO The Tennessean

Tuesday

Mar 22, 2011 at 9:04 AM

NASHVILLE, Tenn. — Claudean Jackson didn’t just lose 110 pounds; she also shed her diabetes. For more than a decade, the 61-year-old Greenbrier, Tenn., resident followed a stringent regimen to control her Type 2 diabetes. Every day she gave herself six insulin shots, took two different types of medications and pricked her finger five times throughout the day to check her blood sugar levels. But then, two months after weight-loss surgery and already 50 pounds lighter, her doctor told her she no longer needed the insulin shots. A month later, she no longer required the pills either.“All I take now is a multivitamin,” says Jackson, who underwent Lap-Band surgery at Baptist Hospital here in December 2009. “That’s it.” Diabetes rates have risen considerably in America. Roughly 26 million Americans — 8 percent of the population — now have the disease. While diabetes is technically considered to be incurable, Jackson and a growing number of patients have managed to become symptom free. Some, like Jackson, have done it via weight-loss surgery although plain, old-fashioned diet and exercise work, too. Although Type 2 diabetes also has genetic factors, excess weight and lack of physical activity are believed to trigger the disease 58 percent of the time, according to the World Health Organization. Not everyone with Type 2 diabetes is overweight, but 80 percent are.“It’s possible to reverse diabetes or prevent it from occurring in the first place through weight loss and exercise,” says Dr. Michael Floyd, associate professor of medicine at Meharry Medical College here. But he cautions, “Diabetes is controllable, not curable. If you gain the weight again, the symptoms will come back. I’ve had a patient who that happened to.”

Improvement can be dramatic With Type 2 diabetes, the body is unable to use the insulin that it produces. Insulin is a hormone that carries sugar to the cells, where it’s converted to energy. When sugar is unable to move into the cells, it builds up in the bloodstream and is converted to a variety of compounds, including fat, which eventually can cause circulatory restrictions, leading to problems such as high blood pressure and vision loss. Floyd said obesity — especially abdominal obesity or belly fat — causes insulin-resistance. That’s why weight loss is beneficial. A study cited in the Journal of the American Medical Association found that diabetes was resolved or improved in 86 percent of patients who underwent weight-loss surgery. Jackson says that beyond the daily hassle of trying to manage her diabetes, her overall health has improved dramatically. Diabetes had caused her vision to blur to the point where she needed prescription glasses, and the nerves in her feet were so damaged that she had difficulty walking.“They were just numb. I didn’t have any feeling,” Jackson says. “I stepped on glass and I didn’t even know that I had cut my feet.” Feeling has returned to Jackson’s feet, and her eyesight also has returned to normal. Her optometrist told her she no longer needs prescription glasses.“I knew if I lost weight it would help me get my sugar under control, but I didn’t expect to have these kind of results,” Jackson says.

Small changes add up The pills that Brenda Morrow took to control her diabetes made her feel worse than the illness itself.“They gave me pains in my stomach,” Morrow says. “It was like a stabbing pain.” Doctors told her that her blood sugar levels “were pushing toward stroke action.” However, Morrow, 60, of Nashville, Tenn., was determined to get off the medication. She started researching diabetes and discovered that weight loss and exercise could make a big difference. She substituted her daily breakfast of bacon, eggs and biscuits with oatmeal and cinnamon toast. She cut out pastas and fried and processed foods, and instead ate more salads and baked foods. Through her efforts, Morrow has lost 40 pounds and no longer takes the medication that makes her feel sick.“I still check my blood sugar three times a day, and it’s fine,” says Morrow, who now weighs about 165 pounds. Richard Pembridge, a diabetes nurse practitioner at Baptist Diabetes Center, said even though weight loss and exercise can produce dramatic results, it’s a hard sell for many patients.“It takes a lot of time and effort to lose weight, but a pill or shot can immediately affect blood sugar,” he says. For those who are serious about wanting to lose weight, Pembridge says small behavior changes — such as cutting out sodas and going on walks regularly — over time really can make a difference. To keep weight off in the long term, Pembridge encourages people to lose no more than one pound a week.“Make attainable goals,” he says. “Start off small and build from there. Sometimes that means just taking a short walk from the house to the mailbox.”

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